Every Saturday The CSPH highlights news or recent research in the field of human sexuality. This week we’re looking at a recent study in the Journal of Sexual Medicine that explores the experiential and social issues that influence women’s postpartum sexuality, specifically “fatigue, body image, mode of delivery, breastfeeding, perceptions of stress, and desire.”

Many studies that look at a women’s postpartum sexuality focus solely on the physical influences (e.g. vaginal trauma, breastfeeding) and intercourse. Therefore, the authors of this study sought to expand both the definition of postpartum sexuality to include masturbation and oral sex and to examine factors such as sexual desire in both the new mother and her partner. This is the first of many things the authors did well in the study.

Participants completed numerous standardized surveys that asked about everything from the details of their pregnancy and delivery to their body image and level of self consciousness. The women in the study ranged from ages 18 to 50, with most being in their mid-20s and -30s. Most were in committed, heterosexual relationships, however a small percentage did not fall into either of these categories. While an even more diverse sample would have been ideal, the authors should be lauded here for their inclusion of mothers of all types.

The researchers had two primary goals in mind for the study: first, it sought to characterize the resumption of various sexual activities, including penetrative intercourse, oral sex, and masturbation, after childbirth. They found that of those women who reported engaging in each of the sexual behaviors before pregnancy, a majority (>60%) also engaged in at least one of them during the first three months following childbirth. Women resumed performing oral sex and engaging in masturbation before they began receiving oral sex or having intercourse. The researchers concluded that this could be due to genital self-consciousness and/or doctor’s orders.

That being said, even if women are not having intercourse right away, of the sexual behaviors studied, women were mostly likely to have it rather than to engage in oral sex or masturbation. Despite this fact, women reported experiencing significantly more enjoyment from masturbation as compared to intercourse or receiving oral sex. Finally, the women’s partners were significantly more likely to initiate postpartum intercourse and oral sex than the new mother.

The study’s second major goal was to examine the factors that most affect sexual desire in the postpartum period. Here again, the authors are exploring something new and admirable. Partner influences played a huge role in determining high sexual desire, specifically how close to or intimate the new mother feels with her partner and how interested her partner is in sexual activity. There was a strong relationship between how women perceived their partner’s desire and their own desire to engage in sexual activity with their partner. Women also reported a strong positive relationship between presence of their partner at birth and their desire for intimacy with that partner, likely because the former factor indicates an already deeply intimate relationship. On the other hand, factors related to fatigue (e.g. personal level, baby’s sleeping habit) and physical issues (e.g. vaginal discomfort or negative body image) most strongly contributed to low sexual desire.

One area where this study excels is its comprehensive examination of the topic. For example, to determine changes in sexual behavior, participants were first asked whether they participated in intercourse, oral sex, or masturbation before their pregnancy and, if so, whether they resumed postpartum, how long it was before they resumed, and their level of enjoyment. Furthermore, by acknowledging that sexual desire may come before the recommended postpartum six-week penetration-free period, the authors were able to expand the conversation around postpartum sexuality to include other activities and provide many jumping off points for future researchers to examine.

Despite these positives, the study is flawed by virtue of it being a retrospective study. A prospective study of women who are trying to get pregnant would provide more accurate detail and not be hampered by the ever pesky recall bias where individuals tend to over- or under-state activity. This bias is especially salient when studying topics that society considers taboo, and there is a body of research suggesting participants of such studies tend to recall and respond in the way they feel is most “right” by society’s standards.